- Paperback: 248 pages
- Publisher: Beacon Press; 1 edition (January 3, 2012)
- Language: English
- ISBN-10: 0807021997
- ISBN-13: 978-0807021996
- Product Dimensions: 6 x 0.7 x 9 inches
- Shipping Weight: 12.6 ounces (View shipping rates and policies)
- Average Customer Review: 4.8 out of 5 stars See all reviews (224 customer reviews)
- Amazon Best Sellers Rank: #36,173 in Books (See Top 100 in Books)
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Overdiagnosed: Making People Sick in the Pursuit of Health 1st Edition
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Frequently Bought Together
*Starred Review* Health policy expert Welch’s assertions about the benefits of some of modern medicine’s most popular diagnostic screening tools are unlikely to ingratiate him with many people. He claims that overdiagnosis “is the biggest problem posed by modern medicine,” and backs that assertion up with a barrage of facts, charts, and graphs. This is information, he says, that is downplayed or simply ignored by individuals and groups promoting the notion that earlier diagnosis—whether for prostate cancer or diabetes—translates to better health. Indeed, Welch says, just the converse is more often true. In an overwhelming number of circumstances, early diagnosis turns healthy, asymptomatic people into patients who require a variety of medical interventions with no benefit, even exposing them to unnecessary harm. Worse, overdiagnosis can render perfectly healthy people uninsurable. Furthermore, instead of lowering health-care costs, all those scans, screenings, and tests actually raise costs by overtreating people who will never benefit from said treatment. His point is that both physicians and patients need to be skeptical and understand all the data (pro and con) surrounding prescreening for possible illness. Welch speaks his truth with a frankness and clarity scant found in today’s hysteria over medical prescreening. --Donna Chavez --This text refers to the Hardcover edition.
“Very insightful and engaging.”—Dennis Rosen, The Boston Globe
“One of the most important books about health care in the last several years.”—Cato Institute
"One of the big strengths of this relatively small book is that if you are inclined to ponder medicine's larger questions, you get to tour them all. What is health, really?... In the finite endeavor that is life, when is it permissible to stop preventing things? And if the big questions just make you itchy, you can concentrate on the numbers instead: The authors explain most of the important statistical concepts behind evidence-based medicine in about as friendly a way as you are likely to find."—Abigail Zuger, MD, The New York Times
"Overdiagnosed —albeit controversial—is a provocative, intellectually stimulating work. As such, all who are involved in health care, including physicians, allied health professionals, and all current or future patients, will be well served by reading and giving serious thought to the material presented."─ JAMA
“Everyone should read this book before going to the doctor! Welcome evidence that more testing and treatment is not always better.”─ Susan Love, MD, author of Dr. Susan Love’s Breast Book
“This book makes a compelling case against excessive medical screening and diagnostic testing in asymptomatic people. Its important but underappreciated message is delivered in a highly readable style. I recommend it enthusiastically for everyone.”─ Arnold S. Relman, MD, editor-in-chief emeritus, New England Journal of Medicine, and author of A Second Opinion: Rescuing America’s Health Care
“This stunning book will help you and your loved ones avoid the hazards of too much health care. Within just a few pages, you’ll be recommending it to family and friends, and, hopefully, your local physician. If every medical student read Overdiagnosed, there is little doubt that a safer, healthier world would be the result.”─ Ray Moynihan, conjoint lecturer at the University of Newcastle, visiting editor of the British Medical Journal, and author of Selling Sickness
“An ‘overdiagnosis’ is a label no one wants: it is worrisome, it augurs ‘overtreatment,’ and it has no potential for personal benefit. This elegant book forewarns you. It also teaches you how and why to ask, ‘Do I really need to know this?’ before agreeing to any diagnostic or screening test. A close read is good for your health.”─ Nortin M. Hadler, MD, professor of medicine and microbiology/immunology at University of North Carolina at Chapel Hill and author of Worried Sick and The Last Well Person
“We’ve all been made to believe that it is always in people’s best interest to try to detect health problems as early as possible. Dr. Welch explains, with gripping examples and ample evidence, how those who have been overdiagnosed cannot benefit from treatment; they can only be harmed. I hope this book will trigger a paradigm shift in the medical establishment’s thinking.” —Sidney Wolfe, MD, author of Worst Pills, Best Pills and editor of WorstPills.org
Top Customer Reviews
Welch provides readers with four important and generalizable points. The first is that, while target guidelines are set by panels of experts, those experts bring with them biases and sometimes even monetary incentives from drug-makers, etc. Over the past decades many target levels have been changed (eg. blood pressure, cholesterol levels, PSA levels), dramatically increasing the number classified as having a particular condition. (Welch adds that prostate cancer can be found at any PSA level - about 8% for those with a PSA level of 1 or less, over 30% for those with a level exceeding 4; most are benign.)
The second is that treating those with eg. severe hypertension benefits those patients much more than treating those with very mild hypertension or 'prehypertension;' the result is treating those with lesser 'symptoms' can easily cause new problems that outweigh the value of the hypertension treatment.
The third is that Welch believes it is usually more important to treat those with disease symptoms (eg. pain) than those without.Read more ›
I have worked in the medical field off and on over the years, and even worked on a prostate cancer project, so I already knew a fair bit about the prostate cancer screening/treatment debate. I learned even more from Dr. Welch.
One question that I have had for years, and that has never been answered to my satisfaction is:
If a person is being treated for cancer, and they die from the treatment (on the operating table, from the drugs/radiation, etc.), do they count in the "deaths from cancer" statistic? I personally have known many more people who died from the treatment itself than who died from the cancer, and yet that particular topic does not get addressed. Are death rates from prostate cancer (for instance) holding steady because the treatments don't work, or because men are dying from unnecessary treatment and that offsets the successful treatments? (I did notice that the death rates for prostate cancer went *up* with an increase in detection in the figure on page 56.)
Statistics are smoky, and it really helps to know more about the study design. Dr. Welch does a very good job of describing the various studies, and their flaws and strengths. I'm sure it is a huge hot potato to discuss death rates from treatment, but I would be very interested in seeing those numbers broken out.
Dr. Welch builds a strong case that Americans are overdiagnosed in a clear, concise and compelling way. He provides anecdotal accounts of people who were seriously harmed by the overzealous use of modern, high tech testing. And he backs these stories up with findings from landmark medical research studies. As we move from chapter to chapter and disease to disease, we see the same patterns emerge: thresholds for "illness" are lowered and suddenly tens of millions of people are diagnosed and treated for mild or nonexistent "diseases" that never would have harmed them.
Dr. Welch identifies the key players who brought American medicine to this sorry state -- big pharma and medical products manufacturers hungry to increase profits, doctors who order unnecessary tests to avoid malpractice lawsuits, and overzealous patient advocacy groups who press for action in the absence of any scientific evidence of improved outcomes.
Dr. Welch explains key concepts like "lag time bias" and "overtreatment bias" that enable you to see why the benefits of aggressive preventive medicine are far less than you have been led to believe. Once you understand terms like these, you will never again be swayed by misleading advertising or public health campaigns.Read more ›
Most Recent Customer Reviews
I listened to this book on Audible (appropriately, in the treadmill) and feel quite vindicated in my refusal of any kind of medical screening over the last 35 years. Read morePublished 6 days ago by J. L. Tucker
Completely ridiculous bulls***, conspiracy theories that are the literal exact opposite of truth.
In personal experience, antidepressants are a life saver, and whatever... Read more
This important book can be read both as an indictment to modern medicine and as a critique to the medicalization of life in general and to the paradigm of “early diagnosis” in... Read morePublished 18 days ago by Alejandro Gaviria
Knew most of this stuff due to many visits to doctors and way too much testing and medications.Published 3 months ago by Tinker
This is one of the best books I've EVER read and I've read thousands. He gives so many examples of how we're overdiagnosed and how one test leads to many, many tests which I find... Read morePublished 3 months ago by JJLOCK
As much as I hate the truth of the contents, it's good to have my own suspicions confirmed.Published 5 months ago by Amazon Customer
If you have read some of the other books on similar topics you might find this book to be redundant and tedious. The writing is extremely clear and easy to follow (to a fault). Read morePublished 5 months ago by plau